| NPI | 1154697258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME122750) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME122750) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2024-01-08 |